University of Wisconsin--Madison

Medical History /History of Science/Afro-American Studies 523: Race, American Medicine and Public Health

Spring 2020 T Th 11-12:15 pm.

Medical Science Center (MSC) 3265

Susan E. Lederer, Ph.D. Robert Turell Professor of History of Medicine and Bioethics

Office 1420 MSC (1300 University Avenue) Office Hours: Tuesday 12:30-1:30 pm, or by appt. selederer@wisc.edu

The problem of the 20th century, wrote sociologist W.E.B. DuBois in The Souls of Black

Folk (1903), “is the problem of the color-line.” This course considers the issue of the color line in American medicine and public health over the past three centuries. We will be looking at the ways in which skin color (and other elements of “racial identity”) has influenced the experiences of patients, physicians and nurses, and medical researchers, seeking to document and analyze how conceptions of race have shaped the health concerns and health outcomes of Americans in the past three hundred years. Topics include the origins of racial classification, the health and medical care of the enslaved, the use of blacks as research subjects, especially the Tuskegee Syphilis Study, the history of racial disparities in medicine, race and reproduction, and the struggle for justice in health care in the second half of the 20th century.

Credits: 3

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This class meets for two, 75-minute class periods each week over the spring semester and carries the expectation that students will work on course learning activities (reading, writing, problem sets, studying, etc) for about 3 hours out of the classroom for every class period. The syllabus includes more information about meeting times and expectations for student work. Prerequisites: None Course Mode of Instruction: Blended. Students must watch the films on-line in advance of coming to lecture/discussion. This course carries Social Science credit and is an Ethnic Studies Course. Ethnic Studies Courses As an Ethnic Studies Course, it has four important goals. It seeks 1) to highlight the ways in which history influences the present; 2) to promote appreciation of critical thinking skills and to encourage a healthy skepticism toward a variety of knowledge claims; 3) to provide students with the opportunity to consider how concepts of ethnic and racial identity influence both individuals and society; and 4) to enhance a student’s ability to participate in a multicultural society more effectively, meaningfully, and respectfully. Learning outcomes: Students, upon successful completion of the course, will be able to: --identify key developments, actors, ideas, and institutions in the broad history of race, medicine and public health in America between 1700 and 2000. -- speak and write critically about primary and secondary historical sources by examining diverse interpretations of past events and ideas in their historical contexts. --ask analytic questions about the ways in which ideas about race and the meaning of racial difference influenced the care patients of color received and how they experienced their illnesses and injuries. -- understand how conceptions of race influenced the medical and nursing professions, as well as medical institutions (dispensaries, hospitals, and blood donation centers). Readings will be drawn from both primary and secondary sources. They will be posted on the course site in Canvas. Course Requirements: Attendance. Attendance is required. Reading and preparation.

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Required book: Wailoo, Keith, and Stephen Pemberton. The troubled dream of genetic medicine: ethnicity and innovation in Tay-Sachs, cystic fibrosis, and sickle cell disease. JHU Press, 2008. Other readings and other materials will be posted on the Canvas course website. Students are expected to study this material as preparation for class discussion. Participation. Discussions are essential to examining the historical, substantive, and cultural complexity of race, medicine and public health. There will be new material presented in class, as well as the opportunity to engage with images and texts—both primary and secondary. This approach requires that you do the reading before class, that you attend class with the goal of raising questions, offering comments, or responding to the readings and the issues they raise. As we are all well aware, ideas about race and assumptions about racial differences are not now nor have they ever been neutral issues; they continue to provoke controversy and discussion. But, we will strive to have our discussions be productive of understanding and tolerance.

Writing Assignments

a. Weekly short quizzes on the readings (starting week 2) b. Generate one set of discussion questions of one reading and begin discussion in class. c. Research paper (10-12 pages in length) on some aspect of the history of race,

medicine, and public health in America. The paper must use both primary and secondary sources as evidence, use footnotes, and include a bibliography. The topic must be approved in advance by the professor. The paper requirement has three parts:

--One page description of paper topic and likely title, initial sources--both primary and secondary, and a paragraph of why this is a question worth asking. --Paper due in class --One-page response to paper comments.

Exams a short (in-class) final exam. IMPORTANT DATES February 27 One page description of paper topic due in class April 21 Paper due in class April 30 One page response to professor comments due in class April 30 Short inclass-final quiz. Grading Quizzes and Participation 30% Discussion questions and beginning discussion 10% Research Paper and one page description 40% Research Paper Response 10% Final exam 10%

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Assignments in the course will be graded on a 4 point scale. A = 3.67-4.0 AB = 3.34-3.66 B = 2.76-3.33 BC = 2.26-2.75 C = 1.6-2.25 D = 1-1.6 F = below 1.0 Policy on late work: Late work shall be penalized one letter grade per day. For example, A to A- for one day, A- to B+ for two days, B+ to B for three days. No assignment will be accepted more than one week late, except for extraordinary circumstances with compelling documentation. Policy on class attendance: Students are required to attend class, to view the films before class discussion, and to complete the reading assignments listed on the course outline in time for class discussions of the material. Discussion is a central part of this class and all students should be able and willing to participate. Absences due to approved university activities, serious illnesses, or a funeral of a close family member must have appropriate documentation to be accepted without penalty. Email policy: I welcome email communications. But, please do not expect immediate responses. I will do my best to return any email messages within 24 hours on weekdays and by Monday for emails sent on Friday afternoon or over the weekend. All students need to ensure that the email address listed for them is accurate and current. Do check the website for basic course information and copies of handouts before emailing me with routine questions. Canvas Website: The course website is a vital component of the class. It contains the list of weekly assignments that you are asked to do to prepare for viewing the film each week, and either the readings for the class or instructions on how to obtain electronic copies from the UW library. Review the Film Notes and sites linked to the film notes pages for a synopsis of the movie (where available) and some commentary on the background of each movie. ACADEMIC INTEGRITY

By enrolling in this course, each student assumes the responsibilities of an active participant in UW-Madison’s community of scholars in which everyone’s academic work and behavior are held to the highest academic integrity standards. Academic misconduct compromises the integrity of the university. Cheating, fabrication, plagiarism, unauthorized collaboration, and helping others commit these acts are examples of academic misconduct, which can result in disciplinary action. This includes but is not limited to failure on the assignment/course, disciplinary probation, or suspension. Substantial or repeated cases of misconduct will be forwarded to the Office of Student Conduct & Community Standards for additional review. For more information, refer to studentconduct.wiscweb.wisc.edu/academic-integrity/. ACCOMMODATIONS FOR STUDENTS WITH DISABILITIES

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McBurney Disability Resource Center syllabus statement: “The University of Wisconsin-Madison supports the right of all enrolled students to a full and equal educational opportunity. The Americans with Disabilities Act (ADA), Wisconsin State Statute (36.12), and UW-Madison policy (Faculty Document 1071) require that students with disabilities be reasonably accommodated in instruction and campus life. Reasonable accommodations for students with disabilities is a shared faculty and student responsibility. Students are expected to inform faculty [me] of their need for instructional accommodations by the end of the third week of the semester, or as soon as possible after a disability has been incurred or recognized. Faculty [I], will work either directly with the student [you] or in coordination with the McBurney Center to identify and provide reasonable instructional accommodations. Disability information, including instructional accommodations as part of a student's educational record, is confidential and protected under FERPA.” http://mcburney.wisc.edu/facstaffother/faculty/syllabus.php Institutional statement on diversity: “Diversity is a source of strength, creativity, and innovation for UW-Madison. We value the contributions of each person and respect the profound ways their identity, culture, background, experience, status, abilities, and opinion enrich the university community. We commit ourselves to the pursuit of excellence in teaching, research, outreach, and diversity as inextricably linked goals. The University of Wisconsin-Madison fulfills its public mission by creating a welcoming and inclusive community for people from every background – people who as students, faculty, and staff serve Wisconsin and the world.” https://diversity.wisc.edu/

TOPIC OUTLINE for 523

Jan 21 Introductions and Expectations Jan 23 Smallpox, Race, and Medical Innovation—Special Guest Professor Emerita Judith Walzer Leavitt Jan 28 Racial Ideas and the Founding Fathers Jan 30 American Hippocrates Feb 4 Scenes of Melancholy Devastation Feb 6 Doctors and Racialized Diseases Feb 11 Experimenting on the Enslaved Feb 13 Legacies of Slavery Feb 18 Reconstructing Health Feb 20 “the Wretched Refuse of your Teeming Shore” Feb 25 Medicalizing the Mexicans Feb 27 Strangers from Another Shore March 3 American Empires

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March 5 Native American Health March 10 Hospitals and Medical Schools March 12 Screening Doctors

March 14-22 Spring Break Mar 24 Red, White and Black Mar 26 The Tuskegee Syphilis Study March 31 Fighting Medical Discrimination April 2 Genetic Medicine— Tay Sachs Disease April 7 Genetic Medicine— Cystic Fibrosis April 9 Genetic Medicine—Sickle Cell Anemia April 14 Affirmative Actions April 16 Reproduction and Race April 21 Surgical Solutions April 23 Disasters April 28 Living with the Past/Present April 30 Conclusions and Review Reading Assignments January 21 Introductions and Expectations January 23 Smallpox, Race, and Medical Innovation —Guest Professor Emerita Judith Walzer Leavitt Readings: Margot Minardi, “The Boston Inoculation Controversy of 1721-1722: An Incident in the History of Race,” William and Mary Quarterly (2004), 47-76. Anne Fausto-Sterling, “Gender, Race, and Nation: The comparative anatomy of “Hottentot” women in Europe, 1815–1817.” (1995) January 28 Racial Ideas and the Founding Fathers

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Readings: Thomas Jefferson, Notes on the State of Virginia (Query XIV) Howard Jones, “Cinqué of the Amistad a Slave Trader? Perpetuating a Myth” with Comments by Paul Finkelman, “Cinqué and the Historians,” Bertram Wyatt Brown, “Mea Culpa,” William S. McFeely, “Cinqué, Tall and Strong,” J Amer Hist (2000), 923-50. January 30 American Hippocrates Readings: Benjamin Rush, “Medicine among the Indians of North America: A Discussion, [1774]” from Selected Writings of Benjamin Rush, pp. 254-92. Benjamin Rush, “Observations Intended to Favour a Supposition That the Black Color (As It Is Called) of the Negroes is The Leprosy,” Trans. American Philosophical Society (1799), 289-97. February 4 Scenes of Melancholy Devastation Readings: Matthew Carey, A Short Account of the Malignant Fever. . . (1794), excerpt. Absalom Jones and Richard Allen, A Narrative of the Proceedings of the Colored People During the Awful Calamity in Philadelphia in the Year 1793; and a Refutation of Some Censures Thrown upon Them in Some Publications. Elizabeth Drinker, The Diary of Elizabeth Drinker, excerpt. February 6 Doctors and Racialized Diseases Readings: Samuel A. Cartwright, “Report on the Diseases and Physical Peculiarities of the Negro Race,” New Orleans Medical and Surgical Journal, (1851). Christopher DE Willoughby, “Running Away from Drapetomania: Samuel A. Cartwright, Medicine, and Race in the Antebellum South,” J. Southern Hist 84, no. 3 (2018): 579-614. February 11 Experimenting on the Enslaved Readings: J. Marion Sims, “Treatment of Vesico-Vaginal Fistula,” Amer. Journal Med. Sciences (1852), 59-82. J. Marion Sims, “Osteosarcoma of the Lower Jaw,” New Orleans Med. & Surg. Journal (1846), 126-29.

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J. Marion Sims, chapter XIV and F. Lee Buxton, “Foreword,” The Story of My Life (1884; 1968), v-xi; 222-46. February 13 Legacies of Slavery Readings: Jay S. Kaufman and Susan A. Hall, “The slavery hypertension hypothesis: dissemination and appeal of a modern race theory,” Epidemiology 14 (2003), 111-18. Osagie K. Obasogie, “Oprah’s Unhealthy Mistake,” Los Angeles Times, May 17, 2007. Owens, Deirdre Cooper, and Sharla M. Fett. "Black maternal and infant health: historical legacies of slavery." American journal of public health 109, no. 10 (2019): 1342-45. February 18 Reconstructing Health Readings: Edward Mayfield Boyle, “A Comparative Physical Study of the Negro,” Journal of the National Medical Association (1912). Leslie A. Schwalm, “Surviving Wartime Emancipation: African Americans and the Cost of Civil War,” Journal of Law, Medicine & Ethics, 2011, 21-28. Stephen C. Kenny, “Capturing Racial Pathology: American Medical Photography in the Era of Jim Crow,” American journal of public health 110, no. 1 (2020): 75-83. February 20 “the Wretched Refuse of your Teeming Shore” Readings: C. P. Knight, “The Detection of the Mentally Defective Among Immigrants,” JAMA 60 (1913), 106-07. Anne-Emanuelle Birn, “Six Seconds Per Eyelid: The Medical Inspection of Immigrants at Ellis Island, 1892-1914.” Dynamis 17 (1997), 281-316. February 25 Medicalizing the Mexicans Readings: J. Colbert, “Hookworm Disease among Mexican track laborers,” Calif State J of Med (1911). Emily Abel, “From exclusion to expulsion: Mexicans and tuberculosis in Los Angeles, 1914-1940." Bulletin of the History of Medicine 77 (2003), 823-49. February 27 Strangers from Another Shore----NOTE: PAPER DESCRIPTION DUE

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Readings: I.E. Cohn, “The Chinese and their Peculiar Medical Ideas,” Medical Record (1892), 477-78. Nayan Shah, “Plague and Managing the Commercial City,” from Contagious Divides: Epidemics and Race in San Francisco’s Chinatown (University of California Press, 2001), 120-57. March 3 American Empires Readings: Warwick Anderson, “Excremental colonialism: Public health and the poetics of pollution,” Critical Inquiry 21 (1996), 640-69. Susan E. Lederer, “’Porto Ricochet’: Joking about Germs, Cancer, and Race Extermination in the 1930s,” American Literary History 14 (2002), 720-46. March 5 Native American Health Readings: Bryan Rindfleisch, “’A very considerable mortality:’ Federal Indian Policy at the Hayward Indian School and Lac Courte Oreilles Reservation,” Wisconsin Magazine of History 94.4 (2011), 2-13. A.J. Chesley, “Is the Indian Susceptible to Health Education?” AJPH (1924). March 10 Hospitals and Medical Schools Readings: W. E. B. Du Bois, The Health and Physique of the Negro American (1906), 93-105. Abraham Flexner, “The Medical Education of the Negro,” Report on Medical Education (1910), Walter White, “Death of a Citizen,” from A Man Called White, 134-38. Spencie Love, “Noted Physician Fatally Injured: Charles Drew and the Legend that Will Not Die,” Washington History (1992), 4-19. March 12 Screening Doctors View Film outside of class : No Way Out (1950)

MARCH 14-22 SPRING BREAK March 24 Red, White and Black

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Readings: S.E. Lederer, “Lost Boundaries: Race, Blood and Bodies” in Flesh and Blood: Organ Transplantation and Blood Transfusion in Twentieth-Century America (2008), excerp Ephemera. White Citizens Council, Mississippi, c. 1950s. March 26 The Tuskegee Syphilis Study Readings: Eunice Rivers, S. H. Schuman, L Simpson, Sidney Olansky, “Twenty years of followup experience in a long-range medical study,” Public Health Reports (1953). W. Montague Cobb, “The Tuskegee Syphilis Study,” J. National Medical Association (1973), 345-48. Thomas Frieden and Francis Collins, “Intentional Infection of Vulnerable Populations in 1946-1948: Another Tragic History Lesson,” JAMA (2010), 2063-64. March 31 Fighting Medical Discrimination Reading: Alondra Nelson, “The People’s Free Medical Clinics,” in Body and Soul: The Black Panther Party and the Fight Against Medical Discrimination (2011). April 2 Genetic Medicine—Tay Sachs Disease Readings: Wailoo and Pemberton, Troubled Dream of Genetic Medicine, intro, chapter 1. April 7 Genetic Medicine—Cystic Fibrosis Readings: Wailoo and Pemberton, Troubled Dream of Genetic Medicine, chapter 2. April 9 Genetic Medicine—Sickle Cell Anemia Readings: Wailoo and Pemberton, Troubled Dream of Genetic Medicine, chapter 3 and conclusion. April 14 Affirmative Actions Readings: Rachel F. Moran, “Bakke's Lasting Legacy: Redefining the Landscape of Equality and Liberty in Civil Rights Law,” UCDL Rev. 52 (2018): 2573-81. Thomas, Billy R., and Nancy Dockter. "Affirmative action and holistic review in medical school admissions: Where we have been and where we are going." Acad Med94, no. 4 (2019): 473-46.

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R. F. Baugh, “I am an African American: Distinguishing between African American and African applicants in medical school admissions matters,” Acad Med 93, (2018): 1281-85. April 16 Reproduction and Race Readings: Follet, Joyce C. "Making Democracy Real: African American Women, Birth Control, and Social Justice, 1910–1960." Meridians 18, no. 1 (2019): 94-151. April 21 Surgical Solutions NOTE: PAPER DUE IN CLASS Readings: Alicia Ouellette, "Eyes wide open: surgery to westernize the eyes of an Asian child." Hastings Center Report (2009). April 23 Disasters Readings: Marian Moser Jones, “Rising to the Surface: Disasters and Racial Health Disparities in American History,” Wash. & Lee J. Civil Rights & Social Justice (2012). Spike Lee, When the Levees Broke: A Requiem in Four Acts (2006), clips. April 28 Living with the Past/Present NOTE: PAPER RESPONSE DUE Readings: Robert B. Baker, Harriet A. Washington, Ololade Olakanmi, Todd L. Savitt, Elizabeth A. Jacobs, Eddie Hoover, and Matthew K. Wynia, “African American physicians and organized medicine, 1846-1968,” JAMA 374 (2008), 306-13. Paul-Emile Kimani, Alexander K. Smith, Bernard Lo, and Alicia Fernández, “Dealing with Racist Patients,” N Engl J Med (2016), 708- 11. Kimberly L. Reynolds, John D. Cowden, Jeffrey P. Brosco, and John D. Lantos. “When a family requests a white doctor,” Pediatrics 136, no. 2 (2015): 381-86. April 30 (Short) In-class final exam. Conclusions

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